Dermatology Department, Hospital Universitario Virgen del Rocío, Sevilla, Spain.
Medicine Department, Universidad de Sevilla, Sevilla, Spain.
Dermatol Ther. 2021 Jan;34(1):e14715. doi: 10.1111/dth.14715. Epub 2021 Jan 6.
Malignant melanoma accounts for 80% of deaths due to skin cancer. Its incidence is globally increasing. However, melanoma mortality seems to be decreasing. The aim of this study was to analyze mortality rates due to melanoma in Andalusia between 1979 and 2018. Deaths due to melanoma and mid-year population in Andalusia were collected from the National Institute of Statistics. Age-adjusted mortality rates were calculated for overall population and for each sex and age group. Regression models were used to calculate significant points of change. Sex ratio and the independent effects of age, period, and cohort were also analyzed. Age-adjusted mortality due to melanoma rose from 0.61 to 1.94 deaths per 100.000 from 1979 to 2018 for the overall population. A significant change of trends was detected around 1994 when, after a steady rise from 1979, mortality rates stabilized up to the end of the period studied. The cited increase was more pronounced in >64 year males. From the end of the 2000s, there was a decrease in mortality rates to date in all population groups, producing a period effect. A stabilization in melanoma mortality rates was observed in Andalusia from 1994 with a decrease in some groups at the beginning of the 21st century. Trends observed in Andalusia do not differ substantially from those in Spain. The development of new therapies and an earlier diagnosis may have an influence in those changes. Studies that compare differences between Spanish regions are needed to define better prevention strategies.
恶性黑色素瘤占皮肤癌死亡人数的 80%。其发病率在全球范围内呈上升趋势。然而，黑色素瘤的死亡率似乎在下降。本研究旨在分析 1979 年至 2018 年期间安达卢西亚地区因黑色素瘤导致的死亡率。黑色素瘤死亡人数和安达卢西亚年中人口数均来自国家统计局。计算了总体人群以及每个性别和年龄组的年龄调整死亡率。使用回归模型计算显著变化点。还分析了性别比例以及年龄、时期和队列的独立影响。1979 年至 2018 年期间，安达卢西亚地区的黑色素瘤年龄调整死亡率从每 100000 人 0.61 例上升到 1.94 例。1994 年左右检测到趋势发生了显著变化，在此之前，死亡率从 1979 年开始稳步上升，直到研究结束时才稳定下来。在>64 岁的男性中，这一增长更为明显。自 21 世纪末以来，所有人群的死亡率都有所下降，产生了时期效应。1994 年以来，安达卢西亚地区的黑色素瘤死亡率趋于稳定，21 世纪初部分人群的死亡率有所下降。安达卢西亚地区观察到的趋势与西班牙的趋势没有太大区别。新疗法的发展和早期诊断可能对这些变化产生影响。需要进行比较西班牙各地区差异的研究，以制定更好的预防策略。
